The Colorectal Program at Lucile Packard Children’s Hospital Stanford is an outpatient program for children who have a history of anorectal malformations (ARM), Hirschsprung’s disease, cloacal exstrophy, and neurogenic bowel that suffer from constipation and/or fecal incontinence. Bowel management involves interventions to provide such children the ability to establish a scheduled colon evacuation of stool to prevent fecal accidents.

The program is designed primarily for children who are of toilet trainable age and suffer from fecal incontinence

• Hirschsprung's Disease
• Imperforate Anus
• Neurogenic Bowel
• Cloacal Exstrophy

The program is designed as a partnership between the family and provider team to best capture the child's stooling pattern and then create an individualized regimen specific to their needs. This may include a variety of imaging or tests, oral laxatives, enemas, dietary education, or referrals to other subspecialty services. The long-term success is confirmed by each family’s satisfaction with and willingness to continue the recommended regimen.

Services include:

• A multidiscipliary clinic with specialists in Pediatric Colorectal Surgery, Urology, and Gynecology.
• A Bowel Management program with laxative/enema programs and support from wound ostomy nurses and Child Life Services.
• Advanced imaging for preoperative planning of anorectal malformations.
• A GI Motility Program using specialized techniques like anorectal and colonic manometry.
• Occupational Therapy for pelvic floor training and biofeedback to address stooling disorders.
• Pregnancy collaborations with with expertise from the Pediatric teams to guide safe OB management.

Before coming to your child's Colorectal Clinic appointment, please be sure to complete the 1-week bowel record for your child and bring it with you. Completing this form will help and enable us to determine the best bowel regimen for your child. 

The trial begins with a clinic visit and includes bowel clean outs, serial x-rays, and adjustments to laxative or enema regimens. You and your child will meet with our colorectal surgeons and advanced practice providers (NP/PA) who will work with you to establish an individualized plan of care. The goal of these trials is to achieve days free of fecal accidents. Trials can be conducted on an outpatient or inpatient basis based on patient need. 

Most of the children who are in this program will need to maintain a bowel management regimen for their entire lives. We are committed to helping them be successful while providing individuaized care. 

For more information about Lucile Packard Children’s Hospital Stanford Colorectal Program, call our office at (650) 723-6439.

The Division of Pediatric General Surgery offers an extensive online resource of general health information. Please do not substitute information on this website for professional advice, a diagnosis of your condition, or a recommendation about the course of treatment for your particular circumstances. This information is not intended to be, and should not be used as, a substitute for medical treatment by a health care professional. You should never disregard or delay seeking medical advice because of what you have read on this website.

• Bristol Stool Form Scale (for children)
• Bowel Record Chart
• Coloplast Peristeen Rectal Irrigation System
• Navina Irrigation System
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